Exercise Crystal: simulations that drive National IHR Focal Point capacity strengthening

ABSTRACT The International Health Regulations (IHR 2005) require States Parties to designate a National IHR Focal Point (NFP) for timely IHR communications with the World Health Organization (WHO) and, following recent amendments, to designate a National IHR Authority to coordinate IHR implementation within States Parties. Since 2008, the WHO Regional Office for the Western Pacific has been supporting the strengthening and testing of NFP functionality through an annual simulation exercise known as IHR Exercise Crystal. This study analyses NFP performance during IHR Exercise Crystal over a 16-year period to inform Member States’ planning for NFP capacity strengthening, in the context of the recent IHR amendments. Exercise monitoring data were analysed using descriptive statistics across six key NFP performance indicators. Findings show consistently high NFP accessibility via email (mean: 99%) but suboptimal NFP accessibility via telephone (mean: 64%). NFP participation in tele- and videoconferences improved over time (mean: 73%), as did the proportion of NFPs notifying WHO of simulated events (mean: 80%) and contributing information to Event Information Site postings (mean: 77%). Multisectoral communication remained variable with no clear trend (mean: 73%). This demonstrates that significant progress has been made and that opportunities remain to further enhance NFP functionality, particularly in the areas of NFP accessibility and multisectoral coordination. It is critical that States Parties continue strengthening and testing NFP functionality through simulation exercises and other capacity-building to ensure effective IHR implementation. Furthermore, States Parties should develop, test and maintain up-to-date SOPs to support the clear demarcation of roles and responsibilities between the NFP and the National IHR Authority.